Purpose

To report outcomes in cases of endogenous endophthalmitis (EE) following COVID-19 infection.

Methods

In a retrospective study, patients with EE, who had a recent history of COVID-19 infection requiring hospital admission were recruited. Data regarding age, gender, the severity of infection, associated systemic illness, duration of onset of ocular symptoms from the time of diagnosis, laterality of the disease, best-corrected visual acuity (BCVA), anterior segment and posterior segment findings were collected from our uveitis clinic database. Microbiological reports of blood culture, urine culture, and vitreous biopsy were also recorded.

Results

Six patients (10 eyes) were included with a mean age of 48+19.80 years and male: female ratio of 2:1. Four patients presented with bilateral EE and two patients had unilateral EE. The mean duration of onset of ocular symptoms from the time of diagnosis of COVID was 28.16+16.15 days. Out of 10 eyes, 8 eyes required surgical intervention, whereas 2 eyes were managed with intravitreal antibiotics. Preoperative BCVA was 2.06+ 0.738 logMAR, which improved significantly to 1.13+ 0.869 logMAR postoperatively. Two patients were positive for Aspergillus fumigatus, two patients were positive for Candida albicans, and two patients had no growth from the vitreous biopsy. Out of two patients with no vitreous growth, one patient showed growth of E.Coli and another patient showed yeast cells in urine culture.The retina was attached in all six patients at mean follow up of 34.33+22.34 days

Conclusions

Prolonged hospital stays and high dose corticosteroid therapy in the management of moderate and severe COVID -19 infection may contribute to systemic immunosuppression and is associated with EE, predominantly fungal endophthalmitis.